HomeMy WebLinkAboutThe Citizen, 2008-10-09, Page 14There is a crisis in healthcare that
goes well beyond the physician
shortage.
They are the Florence Nightingales,
the front-line caregivers who
monitor, comfort and protect.
However, with fewer nurses on the
job, and that number sure to decrease
drastically in upcoming years, who
will be there to support and assist
doctors in patient care?
Grace Harper, a member of the
Nursing Shortage and You committee,
said that it has been projected there
will be a shortage of 78,000 RNs by
2011. If nothing changes that number
is expected to jump to 113,000 by
2016.
“Most hospitals are closing beds,
but people are still getting sick,” said
Harper. “The public will not have
nurses.”
She mentions a situation in a major
trauma centre where there were three
nurses on duty in the critical care
centre. “The norm is 10,” said Harper.
Emergency rooms are falling apart,
she added, telling of two patients
being ventilated in emergency
because there was no one to look after
them. “This is a critical care
situation.”
The reasons are many, said Harper.
First, one must look at the
demographic of the nursing
profession.
“There were 12,000 graduates in
Canada in the 1980s,” said Harper.
“With Harris and his shenanigans that
dropped to 4,000. Now we’re up to
9,446, but the fact that it wasn’t
steady, even if we were at 12,000
again now it wouldn’t be good
enough.”
And there is a change in the way
this new breed of nurses approaches
the job. Liz Phelan, vice-president of
patient care services and chief nursing
executive at Wingham and District
Hospital said, “The younger
generation like to work hard and play
hard. With the older nurses work
often came first. The young nurses
want a work and life balance.”
“That’s why many are getting more
education to be nurse practitioners
which is straight days,” said Harper.
There are currently 90,333 RNs in
Ontario. Of those 1.1 per cent are
under the age of 25, while 54 per cent
are over 45. With the average
retirement age being 56, it has been
estimated that one-third of the nurses
can retire in 2008. “How will our
aging loved ones, or ourselves, be
cared for.”
With the workload increasing
drastically, many young nurses don’t
stick it out, while the older ones
continue to take on more hours and
responsibilities, said Harper. “The stat
for grads leaving the profession is 21
per cent within the first four years due
to workload, unhealthy work
environment and poor retainment
issues,” said Harper, “and the older
ones are over-extended.”
Harper said that some hospitals
have had to call on health care aids to
do “Girl Friday” things, such as
changing bedding. “That’s great, but
they aren’t accountable to a licencingbody as nurses are.”While health care aids can jump into offer support, Harper said thatmany times, even in basic care, anurse can make a physical assessmentof a patient. “We see bumps that
someone else might not normally
see.”
RNs, she explains deal with two
kinds of patients, “unpredictable” and
those in crisis, as well as predictable
and patients not in crisis. RPNs tend
to the last group only.
At least in a perfect healthcare
world. In this world the lines are
blurring. “To handle the RN shortage
we will be looking at RPNs in critical
care. But working outside the scope
of their practice, should there be an
issue, it goes back to the RN licence.”
“This adds to the workload and to
the stress. Where is the patient going
to fare in all this?”
Harper said there has to be the right
mix of RNs and RPNs to deliver the
safe, effective and ethical care that
they are bound by the College of
Nurses to deliver.
Increasing frustrations with the way
nursing is being handled, from
government to management inspired
the formation of the Nursing Shortage
and You committee. “No one is
listening and for nurses there is an
increasing inability to give safe
patient care.”
Also, only 83 per cent of the
graduates are getting full-time. Yet,
said Harper, the total overtime hours
amounted to an estimated 18 million,
“equivalent to 10,000 full-time
nurses.”
“So why do hospitals that are to be
fiscally responsible allow that
overtime rather than hire nurses,” said
Harper.
Hospitals, said Harper, have to start
retaining nurses. “Unless they have a
reason they’re not going to stay.”
Phelan said, at Wingham,
management did see the problem
coming years ago and have tried to
take steps that will help with not just
recruiting nurses, but retaining them.
“We have a very loyal staff here.
There is an aging workforce who have
been extremely dedicated. The issueis to keep them working with suchthings as innovative scheduling.”Phelan said that they have workedwith the local high school’s co-opeducation program to recruit potentialnurses. “We only take ones with an
interest in the health care field and try
to give them as much exposure as
possible.”
Clinical placements with colleges
and universities also help bring nurses
to and develop an appreciation for,
rural areas. “A lot is educating the
universities that students can get good
practical education at a rural site,”
said Phelan.
She feels governments need to do
more to help. “First, the shortage
needs a much higher profile. The
physician shortage has received more
attention, because the average citizen
is upset when they don’t have a
doctor. It publically affects people.
They don’t understand the nursing
shortages as much until they need
direct care.”
Also, she said, politicians need to
be open and honest about the platform
they put forward on agendas. “They
claimed they met the hiring target but
in actual fact many of the graduates
were already nurses who had returned
to school to get their diploma.”
Phelan said incentives to new
graduates to practise in rural areas
would be beneficial.
“And I also feel strongly that they
could expedite the internationally-
trained graduates.”
Harper agrees that government
needs to take the situation seriously.
“They have done some things but they
have known this was coming for over
10 years. They should never have cut
back when they already knew it was
looming.”
So why aren’t they doing more?
“RNAO (Registered Nurses’
Association of Ontario), the College
of Nurses of Ontario and ONA
(Ontario Nurses’Association) have all
talked about it and what should have
been done. It can’t be ignored,
because what will the outcome be.
Are the hospitals, the nursing homes
going to close?”
PAGE 14. THE CITIZEN, THURSDAY, OCTOBER 9, 2008.
Caregiver
Nurse Nancy Rozendal cares for a patient recently admitted into the hospital. With the number
of nurses dropping as a result of a number of reasons, including the fact that many staff are
nearing retirement age and there aren’t enough graduates to fill their spots, nurses are feeling
the stress and their patients are noticing their absence. (Bonnie Gropp photo)
Physician crisis not the only one facing patients
By Bonnie Gropp
The Citizen